By State Representative, Leon D. Young
What is the Republican obsession with block grant funding? For those who may be unfamiliar or unclear with the term, a block grant is a large sum of money given to state and local authorities by the federal government for general purposes, such as transportation, law enforcement or community development.
Like most things in life, there are advantages, as well as disadvantages, to utilizing block grant appropriations. Republicans are always quick to make the case that block grant funding gives states the incentive to seek out and eliminate fraud, waste and abuse to preserve precious fiscal resources. However, detractors argue that block grants lead to less funding over time. Hence, more people in need of vital services are left out in the cold.
It’s no wonder that block granting Medicaid, the nation’s health insurance program for the poor, was a centerpiece of the health proposals offered last month by the president and House Speaker Paul Ryan in their unsuccessful attempt to repeal the Affordable Care Act. Moreover, Trump advisers have emphasized that this strategy is key to the administration’s health policy and reducing health care costs.
Make no mistake, the block grant system is a radical shift from how Medicaid has worked previously. Republicans say it could save the government billions of dollars. But other analysts note those savings could limit access to health care if the funding becomes squeezed. Thanks to the 2010 health law, which led states to expand Medicaid eligibility, more people would face the brunt of those cuts.
The fiscal impact: The non-partisan Congressional Budget Office estimates recent Republican block grant proposals could cut Medicaid spending by as much as a third over the next decade. The cuts would start small, growing larger over the years.
Block grants give Republicans the unfettered flexibility to decide which programs will receive funding; and the freedom to determine who qualifies, and for what services. Moreover, it’s important to note that block grants are an old GOP strategy. How old you ask? This political ploy dates back at least until the 1980s. President Ronald Reagan pushed Medicaid block grants in 1981, House Speaker Newt Gingrich in 1995 and President George W. Bush in 2003.
From the GOP’s perspective, block grant funding, in essence, is the best of both worlds. It provides recipients with a hefty sum of money; with only general provisions as to the way it is to be spent. And, one might argue that block grants are really the GOP’s Trojan horse in terms of fiscal expenditures.